Access to contraceptives top women’s health issue

August 24, 2016

Access to contraceptives and abortion services are the top issues in women’s health care, but respondents to an online survey by MediMedia Research saw a different set of issues surfacing in the near future.

When asked to rank the top five most important issues in women’s health, 40% of the respondents to the survey ranked access to contraceptives as the number one issue, 31% ranked access to abortion services, and 28%, cancer screening. But when they were asked to project ahead to three to five years from now, 78% of the respondents indicated health aging would be among the most important issues in women’s health, and 67% picked screening and treatment of cardiovascular disease and cancer screenings. Only about a third thought access to contraceptives and abortion services would rank among the important issues.

The top-ranked women’s health issues

% of respondents listing issue as the most important

Source for all charts: MediMedia Research

Most important issues for women in 3–5 years

Concerns created by a shifting demographic

MediMedia Research is part of MediMedia Managed Markets, an ICON plc company and owner of Managed Care. Its survey on women’s health issues, which was conducted during the first two weeks of July, garnered replies from 138 respondents. The survey was sent to readers of Managed Care and databases that include health care executives. About 40% of the respondents described their organizations as provider organizations (either medical groups or integrated delivery systems), 20% indicated payer organization or a PBM, and 35% answered “other.”

Almost all (96%) of the respondents agreed with the common observation that women interact more with the health care system than men. “Interact” is deliberately vague, because it encompasses women’s experiences as patients, caregivers, insurance company customers, and, frequently, the managers of the health care of their families.

But, somewhat surprisingly, the respondents were split when asked whether gaining access to health care is more challenging for women than for men. Forty-eight percent agreed that it is and 52% said it is not.

Access to health care more challenging for women than for men

The worries that the respondents have about the barriers to women getting health care are familiar enough. They include the high price of specialty drugs and inadequate health insurance. On a 1–7 scale with 7 being extremely concerned, almost 3 of 4 (72%) rated their concern about those two barriers at 6 or 7. Other barriers they are concerned about include narrow networks, inadequate support networks, and treatment requiring multiple doctor visits.

% who rated their concern about these barriers as high (6 or 7 on a 1–7 scale)

Earlene Biggs, the vice president of market research at MediMedia Managed Markets, notes that high prescription drug costs, inadequate insurance, and access to providers are commonly seen as barriers to health care for both men and women. “The hidden element to this, and the likely reason that the respondents were split on whether access to health care is more challenging for women than for men, is that women can be differentially impacted by the organization and delivery of health care,” Biggs says.

Section 1557 of the ACA bans gender discrimination but only a small fraction (15%) of the respondents said the ban had a major impact on their organization. The majority (69%) had high level of agreement with ACA rules that require insurers to cover health related to pregnancy as an essential health benefit.

Level of agreement with the ACA provisions related to pregnancy benefits

Scale 1–7; 1=Strongly disagree, 7=Strongly agree

There is plenty of evidence that prenatal care significantly lowers health care costs, observes Biggs. “In the current environment of cost containment, quality measures, and paying for outcomes, I am surprised it was only 69% and not unanimous.”

An open-ended question in the survey about how access to health care is more challenging for women yielded a wide range of answers. Several referenced the multiple responsibilities shouldered by women and economic hardship.

“Women manage their own access to health care and that of others—children, elderly parents, and even their spouses,” wrote one respondent. “In addition, the burden of care logistics is greater. For primary care, a women often has to see different providers for general health and reproductive health. Add to that less coverage and higher costs for health issues that are typically experienced by more women.”

Another wrote, “Child care, work, caring for family usually take precedence over health care for herself. Also, economic concerns may hold her back.”

Several respondents mentioned problems with insurance coverage, especially Medicaid, and shortages of providers that disproportionately affect women. The number of physicians taking new Medicaid patients is declining, noted two respondents, especially in obstetrics and pediatrics. Another comment: women outlive men, so they are more affected by the shortage of geriatricians. Economic disadvantage was a recurring theme: One respondent wrote that single moms and women can’t afford good insurance and, furthermore, employers are cutting hours so there are more jobs without health benefits.

Another respondent had a different line of analysis about gender disparity in health. Men’s diseases tend to get more attention and therefore access to treatments for those diseases is easier, the person wrote, adding that “women’s diseases such as PCOS [polycystic ovary syndrome] may get thrown in with infertility (which is often not covered) rather than being seen as a legitimate condition that needs treatment.”